not sure what to do

[woven]

Hi, here's a little history first, i have had 6 hospital births 2 doctors and 4 nurse midwives.
all my labors have been 36 hours or more the last 4 were induced past 41 weeks 1 c section and two vbacs with the last one a still born at 39 weeks due to placenta abruption (too much amniotic fluid i believe was the cause )anyway...
I am 32 weeks and we found out again the amniotic fluid is high and I have gestational diabetes. Now I can no longer see my midwife, I do have an appointment with a Doctor this week and I am scared that they will not give me a chance to have another vbac. I do know the baby's life is more important than the birth experience. I just feel sick about seeing a Doctor I feel like they will violate my birth rights or something. Im afraid that if this Doctor wont let me try for my vbac I may walk out with no Doctor. Normally I would be fine with a homebirth but I feel I would be scared because of the last stillborn so late. Not sure what advice I need, but I will accept any!

[mollikins]

First off, don't panic!! There are plenty of open-minded OBs in the world, you just have to find one. Given your situation, I honestly don't know what the safest/best delivery course would be for your baby - I don't know if a prior abruption increases your chances of it happening again, or how they manage the amniotic fluid levels if at all, etc. It is definitely something you want to talk about with your doc.

I would recommend contacting your local ICAN (www.ican-online.org) group and see if you can find a VBAC-friendly OB in your area. Once that is accomplished, you can sit down and discuss with him or her what your options are and make a decision from there.
Best of luck to you and your baby!

[woven]

Thanks

I just registered with Ican earlier today i looked up Ican providers and they said that ther are none in Ohio.
If i control my gestational diabetes then usually the amniotic fluid goes down, because the need for the baby to urinate frequently decreases which the risk of placenta abruption also decreases. Thanks for the info!

[AustinMom]

The only thing I can suggest is, if it is GD causing the issues, eliminate sugars, grains, and all refined foods. Agave nectar is safe as it doesn't raise blood sugar, but I'd even avoid that, so you don't crave the sweets. You only have to do this till the baby is born anyway, and you are most likely already doing most of this now. I'd go on a pretty strict diet though, to help with the fluid, if that is being caused by the GD.

[mollikins]

That stinks that there are no ICAN providers near you, but it's not the end of the world. Do you have a choice in docs, or are you limited by your insurance?
You may just have to call around and do a lot of interviewing/question asking. There are no ICAN providers where I live either, but I am fortunate that my OB is very open to VBAC (she's just really laid-back in general, which is nice). A starting list of questions to ask:

1) given your vaginal birth history (i.e. 5/6 children birthed vaginally), are they willing to let you do another VBAC?

2) What are the specific risks of abruption given your medical history, and how would they manage that risk?

3) what sort of 'rules' do they have for VBAC (i.e. what will they/won't they allow you to do).

I'm sure there are tons more, those are just a few off the top of my head.

Good luck!

[kathan12904]

They can't do anything to you that you don't consent to, thats called assault. If you get to the hospital in labor and don't consent to EFM, staying in bed, c/s, etc, they can't force you to, especially if you have a supportive partner who will help you stand up for yourself. Honestly, most of the requirements hospitals put on you can be avoided by signing a form that says you won't sue them if something goes wrong. These hospital demands aren't based on what is safest for their patients, but on requirements that their malpractice insurance companies have for their coverage. A simple form can get rid of that problem and no matter what they tell you (had a nurse lie about this to a client of mine), there is a form.

[MNHall]

I'm not sure if I followed the ICAN part or not, but we do not have an ICAN chapter anywhere close to me, however, I have been able to find an EXTREMELY supportive OB in my area. One that does VBAC's, VBA2C's, he will let you push for 4 hours, and so on. He has a great natural labor additude, and just an over all great birth additude. His take on things is to be there to catch the baby. He's really more like a midwife! I'm not saying that there HAS to be a doctor like this out there in your area, but it's taken me until TTC #3 to find this OB!

Just wanted to add that in since I know I was first refered to ICAN and found that as a dead end for me!

[3tammuz]

Hugs to you. I would talk honestly and openly to your doctor. You never know whether they will be supportive or not. Talk about the risks, your desires and see if you match. Jsut b/c you have to use an OB, does not mean you absolutely can't get your VBAC.

You could also ask people in your Tribal area for recommendations for natural,VBAC-friendly OBs in your area.

Best of luck.